Increasing Prevalence of Type 2 Diabetes in a Rural Bangladeshi Population: A Population Based Study for 10 Years

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D I A B E T E S & M E T A B O L I S M J O U R N A L

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Increasing Prevalence of Type 2 Diabetes in a Rural Bangladeshi Population: A Population Based Study for 10 Years (Diabetes Metab J 2013;37:46-53)

Nan Hee Kim

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Corresponding author: Nan Hee Kim

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, 123 Jeokgeum-ro, Danwon-gu, Ansan 425-707, Korea

E-mail: [email protected]

Dear Editor,

In recent years, there has been rapid growth in the prevalence of diabetes, particularly in Asia. This region contains some of the most populous countries in the world, and has undergone pronounced demographic, epidemiologic, and socioeconomic change in recent decades [1]. Indeed, the prevalence of diabetes in Korea has increased from 1.5% to 9.9% in the past 40 years [2]. Bhowmik et al. [3] demonstrated a similarly significant rise in the prevalence of diabetes in Bangladesh, from 2.3% in 1999 to 7.9% in 2009. This rapid increase was attribut- ed to the dramatic socioeconomic and lifestyle changes ac- companying urbanization in rural Bangladeshi communities;

however, these changes were not well documented. If it is pos- sible, demonstrating changes of dietary habits, exercise and occupation during study period may make the present finding more reliable.

Secondly, although waist-hip ratio (WHR) was a significant risk factor for diabetes in men, the odds ratio (OR) for WHR was significant in women only in 2009. This may be due to the small number of subjects with WHR <0.8, which is a refer- ence group in women. It may be more useful to divide WHR into <0.8, 0.8 to 0.9, ≥0.9 as the authors did for body mass in- dex. Alternatively, the OR of waist circumference rather than WHR could be used to present the importance of central obesity.

Lastly, it is unclear why the prevalence of hypertension show- ed a decreasing trend over the follow-up period. Increased

awareness and treatment of hypertension may not be responsi- ble for this finding, since it can improve blood pressure level and overall health in patients with hypertension, but does not affect the documented prevalence of hypertension. It may also be important to check the method of blood pressure measure- ment to exclude systematic error. As the authors indicated, lon- gitudinal data obtained from a nationally representative sample may present more reliable results for the prevalence of hypertension.

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was re- ported.

REFERENCES

1. Yoon KH, Lee JH, Kim JW, Cho JH, Choi YH, Ko SH, Zimmet P, Son HY. Epidemic obesity and type 2 diabetes in Asia. Lan- cet 2006;368:1681-8.

2. Kim DJ. The epidemiology of diabetes in Korea. Diabetes Metab J 2011;35:303-8.

3. Bhowmik B, Afsana F, My Diep L, Binte Munir S, Wright E, Mahmood S, Khan AK, Hussain A. Increasing prevalence of type 2 diabetes in a rural Bangladeshi population: a population based study for 10 years. Diabetes Metab J 2013;37:46-53.

Letter

http://dx.doi.org/10.4093/dmj.2013.37.2.152 pISSN 2233-6079 · eISSN 2233-6087